Democratic governors: Obama needs to sell Obamacare

With the battle over Obamacare moving from Washington to the states and a deluge of ads battering the law on TV, Democratic governors delivered a message to President Barack Obama over the weekend: We need help.

Four years out from passage of the Affordable Care Act, it’s state executives in Obama’s party who may be bearing the heaviest load when it comes to making the law work and selling it to voters. They’ve grappled with their own glitch-ridden enrollment sites and fought their own legislatures over Medicaid expansion.

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Now, many of them are running for reelection with the ACA hanging over their heads — and only a limited effort from national Democrats and their president to reverse the consistently negative public opinion of the law.

Asked if the White House had done enough to win over the public on the ACA, Massachusetts Gov. Deval Patrick replied: “The short answer is no.”

Patrick said he didn’t mean that as a “critique” of the president, but he’s not the only governor who would like to see the White House do more.

Missouri Gov. Jay Nixon told Obama at a closed-door meeting of Democratic governors Friday that the president should do more to play up health care innovations unfolding at the state level. Delaware Gov. Jack Markell said he had counseled senior White House officials to highlight efforts to control health care costs, rather than simply telling now-familiar stories about patients with pre-existing conditions who now have access to health insurance.

As for Patrick, he said he was only noting that there hasn’t been a sustained effort to promote the ACA of the sort Massachusetts health care reformers assembled during the state’s 2006 overhaul.

“We had this coalition of business and labor, policymakers, the medical industry, patient advocates and so on, who helped invent health care reform and then stuck together to refine it and improve it,” recalled Patrick, who is leaving office next year after two terms. “It’s not a critique; it’s an observation that not only did we sell it, but we had allies in selling it. I think the president hasn’t had those advantages.”

Democrats across the party — not just governors — have raised a hue and cry in recent weeks as conservative outside groups, led by the heavy-spending behemoth Americans for Prosperity, have burned tens of millions of dollars on ACA-bashing ads early in the midterm election season. There is no comparably funded effort on the Democratic side, and a half-dozen senior party strategists said that none is currently anticipated.

Insurers, desperately eager to convince people to sign up for health care policies, have poured millions into an ad campaign of their own, but there’s little indication those ads have served as a political counterweight.

White House aides say there’s a good reason why blue-state governors might not have heard much from the administration lately. For the most part, officials have been focused less on larger Obamacare messaging and more on an intense effort to reach uninsured Americans, particularly in big states with uncooperative GOP governors, such as Texas and Florida.

In places like these, the president, first lady Michelle Obama and Vice President Joe Biden have been touting the ACA on the radio, with an emphasis on black and Latino audiences. They’re also turning to social media: Administration aides have largely given up counting on the press to cover positive stories about Obamacare they’ve tried pumping out, and instead point to the viral traffic they got from having Julia Louis-Dreyfus and other celebrities tweet with the #getcovered hashtag.

“In the places where you have a high density of uninsured, you’d be hard-pressed not to find an active administration voice,” said a senior administration official. “We’re doing what we think works, and what we think reaches the most people.”

Still, in the absence of a stronger pro-ACA message emanating from Washington, governors — like Senate and House candidates — have essentially fought out the issue state by state. They have sought to persuade their constituents that they should accept federal funds for Medicaid expansion, work through the technical problems with numerous state exchanges and patiently await the benefits of the ACA’s transformation of the health care market.

At a POLITICO event after the Democratic governors’ meeting with Obama, Nixon said there hasn’t been enough emphasis on how states are working to “get better health outcomes” within the larger framework of the ACA. “Having the administration and others talk more about those reforms within the Medicaid system, I think would be helpful,” said Nixon, a popular Democrat who has been blocked from accepting federal health care funds by a GOP legislature.